Effectiveness of psychological interventions on treatment adherence and quality of life in breast cancer survivors: A systematic review and meta-analysis

Objective: To evaluate the impact of psychological interventions on treatment adherence and quality of life in breast cancer survivors. Methods: A systematic review and meta-analysis of 42 randomized controlled trials (2002-2023). Interventions included Cognitive-Behavioral Therapy (CBT), Mindfulness-Based Interventions (MBI), and Supportive-Expressive Group Therapy (SEGT). Primary outcomes assessed were treatment adherence and quality of life. Key Findings: Treatment Adherence: Psychological interventions significantly improved adherence (RR = 1.27, 95% CI: 1.18-1.37), with CBT showing the largest effect (RR = 1.35). Interventions lasting >= 8 weeks were more effective. Quality of Life: Moderate improvements were observed (SMD = 0.45, 95% CI: 0.36-0.54), with MBI having the strongest impact (SMD = 0.56). Interventions of >= 12 weeks yielded better outcomes. Metaregression: Longer interventions were linked to larger effects for both adherence and quality of life. Conclusions: CBT and MBI significantly enhance treatment adherence and quality of life in breast cancer survivors, especially with longer interventions. Psychological support should be integrated into comprehensive cancer care.